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IMPROVING HEALTH FOR VERY PRETERM CHILDREN IN EUROPE

Published articles

Use of evidence based practices to improve survival without severe morbidity for very preterm infants: results from the EPICE population based cohort

Jennifer Zeitlin, Bradley N Manktelow, Aurelie Piedvache, Marina Cuttini, Elaine Boyle, Arno van Heijst, Janusz Gadzinowski, Patrick Van Reempts, Lene Huusom, Tom Weber, Stephan Schmidt, Henrique Barros, Dominico Dillalo, Liis Toome,  Mikael Norman, Beatrice Blondel, Mercedes Bonet, Elisabeth S Draper, Rolf F Maier, and the EPICE Research Group
BMJ (2016)


Evidence-based practices are shown to improve health outcomes in children born preterm in randomised trials, but their use and impact in routine clinical practice remain poorly understood. We studied the implementation of high-evidence practices to assess whether they constitute a lever for reducing mortality and morbidity in children born preterm.

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Evidence-based neonatal unit practices and determinants of postnatal corticosteroid-use in preterm births below 30 weeks GA in Europe. A population-based cohort study

Nuytten A, Behal H, Duhamel A, Jarreau PH, Mazela J, Milligan D, Gortner L, Piedvache P, Zeitlin J, Truffert P on behalf of the EPICE (Effective Perinatal Intensive Care in Europe) Research Group
PloS One (2017)


Postnatal corticosteroids (PNC) were widely used to treat and prevent bronchopulmonary dysplasia in preterm infants until studies showed increased risk of cerebral palsy and neurodevelopmental impairment. We found that PNC are still frequently used in Europe, but with wide regional variation that was unexplained by neonatal characteristics. Even for infants at highest risk for PNC use, some regions only rarely prescribed PNC. A stated policy of reduced PNC use was associated with observed practice and is recommended.

See full article here: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0170234

Use of Magnesium Sulphate before 32 weeks of gestation: a European population-based cohort study

Wolf HT, Huusom L, Weber T, Piedvache A, Schmidt S, Norman M, Zeitlin J and the EPICE Research Group
BMJ Open (2017)


Magnesium sulphate has long been used in obstetric practice, but its current use is unknown. We aimed to explore reported policies of use of magnesium sulphate and the actual use in European obstetrical units by indication (eclampsia prophylaxis, fetal neuroprotection and tocolysis) in women giving birth before 32 weeks of gestation. We used data from the European Perinatal Intensive Care in Europe (EPICE) population-based cohort which is a large population-based multinational cohort.

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Patent ductus arteriosus treatment in very preterm infants: a European population-based cohort study (EPICE) on variation and outcomes

Edstedt Bonamy AK, Gudmundsdottir A, Maier RF, Toome, L, Zeitlin J, Bonet M, Fenton A, Børch Hasselager A, van Heijst A, Gortner L, Milligan D, Van Reempts P, Boyle EM, Norman M and collaborators from the EPICE Research Group
Neonatology (2017)


Spontaneous closure of patent ductus arteriosus (PDA) occurs frequently in very preterm infants and despite the lack of evidence for treatment benefits, treatment for PDA is common in neonatal medicine. We found that PDA treatment varies largely across Europen without associated variations in perinatal characteristics or neonatal outcomes. This finding calls for more uniform guidance for PDA diagnosis and treatment in very preterm infants.

See article here: https://www.karger.com/Article/Abstract/454798

Maternal Education Is Associated with Disparities in Breastfeeding at Time of Discharge but Not at Initiation of Enteral Feeding in the Neonatal Intensive Care Unit

Herich LC, Cuttini M, Croci I, Franco F, Di Lallo D, Baronciani D, Fares K, Gargano G, Raponi M, Zeitlin J; Italian Effective Perinatal Intensive Care in Europe (EPICE) Network
J Pediatr. (2016)


In this population-based cohort of very preterm infants, we found a significant and positive association between maternal education and the likelihood of receiving their mother's own milk at the time of discharge. In light of the proven benefits of maternal milk, strategies to support breastfeeding should be targeted to mothers with less education.

 See full article here: http://www.sciencedirect.com/science/article/pii/S0022347616311799

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